Rapid point-of-care test for diagnosis of peritonitis in peritoneal dialysis patients.

Background: Periplex is a rapid point-of-care test based on the detection of interleukin-6 (IL-6) or matrix metalloproteinase-8 (MMP-8) to diagnose peritonitis in peritoneal dialysis (PD) patients.

Methods: This single-centre study was conducted in Singapore General Hospital from 2019 to 2022. The study recruited PD patients suspected of having peritonitis.

Development and deployment of a nationwide predictive model for chronic kidney disease progression in diabetic patients.

Aim: Chronic kidney disease (CKD) is a major complication of diabetes and a significant disease burden on the healthcare system. The aim of this work was to apply a predictive model to identify high-risk patients in the early stages of CKD as a means to provide early intervention to avert or delay kidney function deterioration.

Materials And Methods: Using the data from the National Diabetes Database in Singapore, we applied a machine-learning algorithm to develop a predictive model for CKD progression in diabetic patients and to deploy the model nationwide.

Exploration of patients' preference for modalities of care among peritoneal dialysis patients in Singapore: a single-center experience.

Introduction: Peritoneal dialysis (PD) is home-based dialysis therapy and therefore a suitable modality for kidney failure patients, particularly, during the COVID-19 pandemic. The present study examined patients' preferences for different PD-related services.

Methods: This was a cross-sectional survey study.

Clinical features, management and outcomes of peritoneal dialysis patients during Delta and Omicron waves of COVID-19 infections.

Introduction: There were discrete outbreaks of SARS-CoV-2 infection in 2021 (Delta wave) and 2022 (Omicron wave) in Singapore, which affected patients receiving peritoneal dialysis (PD).

Methods: This study included all PD patients with COVID-19 infection from a single center between October 2021 and March 2022. The clinical presentation, management and outcomes of patients during the Delta and Omicron outbreaks were compared.

Validation of the kidney failure risk equation in predicting the risk of progression to kidney failure in a multi-ethnic Singapore chronic kidney disease cohort.

Introduction: The Kidney Failure Risk Equation (KFRE) was developed to predict the risk of progression to end-stage kidney disease (ESKD). Although the KFRE has been validated in multinational cohorts, the Southeast Asian population was under-represented. This study aimed to validate the KFRE in a multi-ethnic Singapore chronic kidney disease (CKD) cohort.

COVID-19 vaccination in peritoneal dialysis patients.

Background: COVID-19 vaccine is recommended in Peritoneal dialysis (PD) patients, but a paucity of data is available regarding vaccine-related adverse effects among PD patients.

Method: A cross-sectional study was conducted in a single center between October and November 2021. PD patients were provided with the online survey link to participate in the study.

Healthcare professionals' perspectives on facilitators of and barriers to CKD management in primary care: a qualitative study in Singapore clinics.

Introduction: The burden of chronic kidney disease (CKD) is rising globally including in Singapore. Primary care is the first point of contact for most patients with early stages of CKD. However, several barriers to optimal CKD management exist.

Effectiveness and acceptability of a multidisciplinary approach in improving the care of patients with advanced chronic kidney disease: a pilot study.

Objective: This study aimed at determining the feasibility of conducting a large-scale pragmatic effectiveness study on the implementation of multidisciplinary care (MDC) program for patients with advanced chronic kidney disease (CKD).

Methods: This is a single-arm pre-post intervention design pilot study over 12 months. Participants with an estimated glomerular filtration rate (eGFR) between 11 and 20 ml/min/1.

Improving influenza and pneumococcal vaccination uptake among incident peritoneal dialysis patients: a quality improvement initiative.

Introduction: Influenza and pneumococcal vaccination rates among peritoneal dialysis (PD) patients remain suboptimal, despite availability of vaccinations and health recommendations.

Aim: The primary aim was to improve influenza and pneumococcal vaccination rates among incident PD patients at our center to 80%. A secondary aim was to develop a sustainable workflow for vaccination in PD patients.

Strategies for Management of Peritoneal Dialysis Patients in Singapore during COVID-19 Pandemic.

Peritoneal dialysis (PD) is the only well-established home-based dialysis therapy in Singapore. As it is a home-based modality, PD should be considered as a preferred mode of kidney replacement therapy (KRT) for patients with kidney failure during this COVID-19 pandemic as it avoids frequent visits to hospitals and/or satellite dialysis centres. The highly infectious nature of this virus has led to the implementation of the Disease Outbreak Response System Condition orange status in Singapore since early February 2020.

Effect of short-term low molecular weight heparin on patency following successful salvage of arteriovenous access with recurrent thrombosis.

Aim: This study aims to investigate the effect of low molecular weight heparin (LMWH) in maintaining the patency of arteriovenous (AV) access with recurrent thrombosis.

Methods: Following successful thrombectomy, 66 patients with recurrent thrombosis were included in the study. The primary, assisted primary and secondary patency rates of patients who received LMWH (n = 24) were compared with those who did not receive anticoagulant (n = 42) using Kaplan-Meier analysis.

Chlorhexidine-impregnated sponge dressing for prevention of catheter exit-site infection in peritoneal dialysis patients: a pilot study.

Purpose: The study aimed to examine effect of chlorhexidine dressing in the prevention of peritoneal dialysis (PD)-related infection in PD patients.

Methods: This single-center pilot study recruited 50 incident PD patients to use weekly chlorhexidine dressing. The primary outcome was exit-site/tunnel infection rate.

Comparison of outcomes of urgent-start and conventional-start peritoneal dialysis: a single-centre experience.

Background: There has been a growing interest in urgent-start peritoneal dialysis (PD) in patients with end-stage kidney disease to avoid central venous catheter use and its complications. This study aimed to compare clinical outcomes between urgent-start PD (defined as PD commencement within 2 weeks of PD catheter insertion) and conventional-start PD.

Methods: This was a single-centre retrospective cohort study of all incident PD patients at Singapore General Hospital between January 2017 and February 2018.

Hepatitis C virus antigen detection is an appropriate test for screening and early diagnosis of hepatitis C virus infection in at-risk populations and immunocompromised hosts.

Early diagnosis remains key for effective prevention and treatment. Unfortunately, current screening with anti-hepatitis C virus antibody (anti-HCV Ab) test may have limited utility in the diagnosis of HCV infection and reinfection. This is of special concern to at-risk population, such as immunocompromised hosts and end-stage renal failure patients on hemodialysis.

Healthcare professionals' perceptions of the role of a multidisciplinary approach in improving the care of patients with advanced chronic kidney disease.

Objective: To explore and understand the experiences of healthcare professionals (HCPs) delivering care in a multidisciplinary care (MDC) clinic for advanced chronic kidney disease (CKD) patients.

Methods: This is a qualitative study based on semi-quantitative questionnaire and semi-structured interviews with thematic analysis and deductive mapping onto the Theoretical Framework of Acceptability. Sixteen HCPs caring for advanced CKD patients in a MDC clinic in a tertiary teaching hospital in Singapore were recruited based on maximum variation sampling procedures.

Early technique failure in peritoneal dialysis patients in a multi-ethnic Asian country.

Purpose: Early technique failure is a serious complication for peritoneal dialysis (PD) patients. The study aimed to examine the incidence, causes, and risk factors associated with early technique failure.   METHODS: This retrospective study included all incident PD patients in a hospital in Singapore from 2013 to 2017.

Study protocol of a pilot study on sirolimus-coated balloon angioplasty in salvaging clotted arteriovenous graft.

Background: In arteriovenous graft (AVG) for haemodialysis, the primary cause of failure is venous stenosis of the graft-vein junction from neointimal hyperplasia (NIH), resulting in thrombosis. While interventions to salvage clotted AVG are known to have high clinical success rates, long-term patency rates have been suboptimal. Drug-coated balloon (DCB) has been used to treat stenosed arteriovenous access in recent years with encouraging results but data on its effect in clotted AVG is unavailable.

Current state of vascular access in Singapore.

This article described the current state of vascular access management for patients with end-stage renal disease in Singapore. Over the past 10 years, there has been a change in the demographics of end-stage renal disease patients. Aging population and the increase in prevalence of diabetes mellitus has led to the acceleration of chronic kidney disease and increase in incidence and prevalence of end-stage renal disease.

Outcomes of endovascular salvage of clotted arteriovenous access and predictors of patency after thrombectomy.

Objective: This study aimed to report the outcomes of endovascular salvage of clotted arteriovenous (AV) accesses and to determine potential predictors of poor patency rates after thrombectomy.

Methods: Records of hemodialysis patients who underwent endovascular salvage of clotted AV access were reviewed retrospectively. Technical and clinical success rates, complication rates, and 3- and 6-month patency rates were determined.

Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients.

Introduction: A successful arteriovenous fistula is essential for effective haemodialysis. We aim to validate the existing failure to maturation equation and to propose a new clinical scoring system by evaluating arteriovenous fistula success predictors.

Methods: Data of end-stage renal disease patients initiated on haemodialysis from January 2010 to December 2012 were retrospectively obtained from medical records with follow-up until 1 January 2014.

Augmented Adsorptive Blood Purification during Continuous Veno-Venous Haemodiafiltration in a Severe Septic, Acute Kidney Injury Patient: Use of oXiris®: A Single Centre Case Report.

The use of the oXiris® haemofilter during continuous veno-venous haemodiafiltration (CVVHDF) for acute kidney injury (AKI) and severe sepsis is not completely understood. Although this filter has in vitro adsorptive properties for blood-borne cytokines and other humoural mediators of sepsis, its clinical usefulness is uncertain. Given its inherent adsorptive limitation for septic mediators, we developed a CVVHDF protocol in which the oXiris haemofilter was electively changed every 12 h even though there was no clotting or adverse circuit pressures.

Comparison of Clinical Presentation and Outcomes of Peritonitis in the Elderly and Younger Peritoneal Dialysis Patients.

Background: The incidence of elderly patients receiving peritoneal dialysis (PD) has increased. This study aimed to examine the clinical presentation and outcomes of peritonitis in elderly PD patients compared with younger PD patients.

Methods: This single-center, retrospective, observational cohort study included all adult PD patients who developed peritonitis between January 2011 and December 2014.